Introduction Inadequate health literacy is a pervasive problem with major implications for reduced health status and health disparities. Despite the role of focused education in both primary and secondary prevention of stroke, the effect of health literacy on stroke education retention has not been reported. We examined the relationship of health literacy to the retention of knowledge after recommended stroke education.

The hemodynamic effects of beta-receptor blocking agents on the ejection fraction of patients with coronary artery disease during exercise have been studied previously using radionuclide techniques. Left ventricular volume measurements and the peak systolic pressure/end-systolic volume (PSP/ESV) index have been shown to be variables of left ventricular function that are less influenced by preload and afterload than is ejection fraction. Left ventricular volumes and PSP/ESV were therefore measured in 18 patients with proven coronary artery disease in the control state and after 2 weeks of daily maintenance therapy with either 240 mg propranolol or 60 mg timolol. Values at rest and during symptom-limited upright exercise were compared using the first pass technique and a multicrystal scintillation camera. Left ventricular volumes were measured by the area-length method. Because there was no difference between the propranolol and timolol groups, the results for both groups were combined. The ejection fraction at rest after beta-receptor blocker treatment was not significantly different from pretreatment measurements because of an increase in both end-diastolic and end-systolic volumes (p less than 0.01). However, the value for peak systolic pressure/end-systolic volume (PSP/ESV) index at rest was lower after treatment. The exercise ejection fraction was greater after treatment (p less than 0.01), owing to an increase in end-diastolic volume and unchanged end-systolic volume. In addition, there was a significant improvement in the directional change in the PSP/ESV ratio between rest and exercise from pretreatment to treatment (-1.1 +/- 2.5 to +0.2 +/- 1.2, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

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Introduction: Nurses who provide inpatient care to acute ischemic stroke (AIS) patients routinely perform neurologic assessments that are intended to monitor the stability of neurological deficit. A variety of assessment tools are used, however none of these tools have been validated as a stroke specific assessment tool for nurses. The purpose of this study was to evaluate the validity of a novel nurse performed stroke assessment tool, the Post Stroke Assessment Tool (PSAT). Methods: An interdisciplinary team, from a single certified primary stroke center devised the PSAT. The PSAT encompasses evaluation of 4 components of neurologic function (level of consciousness, cranial nerves, limb strength, and limb coordination). PSAT scores range from 0 (no deficits) to 63. A Clinical Nurse Educator trained neurology nurses on PSAT performance prior to study initiation. A nurse performed the PSAT on patients with AIS. A physician performed the National Institutes of Health Stroke Scale (NIHSS) within 30 minutes of PSAT completion. General linear regression and Pearson correlation was used to evaluate the relationship between scores. All analysis was done in SAS® Version 9.3 for Windows. Results: A total of 26 nurses conducted a PSAT on 46 patients. Mean NIHSS was 6.1 (S.D. +/- 6.9) and mean PSAT score was 10.2 (S.D. +/- 11.8). The r 2 was 0.8349. Overall, the model was significant (p-value < 0.0001). Both the regression model and Pearson correlation showed a significant relationship between PSAT and NIHSS (p <0.0001 for both). Spearman correlations showed a significant relationship between PSAT and NIHSS within each category (p < 0.003 for each category). Conclusions: In this exploratory study, the PSAT appears to be a reliable nursing assessment tool to monitor post stroke neurologic deficit. Total and categorical PSAT scores highly correlated with total and categorical NIHSS scores. No attempt to compare inter-rater reliability from one nurse to another was included in this study. Future research concerning the reliability of the PSAT will be necessary before this tool can become a standard nursing assessment for patients following AIS.